Ten minutes after receiving DPT vaccine, a 7-week-old infant develops generalized urticaria, stridor and hypotension. The medical officer diagnoses anaphylaxis. What is the correct initial dose of adrenaline?
- A Adrenaline 1:1000, 0.5 mg subcutaneously regardless of weight
- B Adrenaline 1:10,000, 0.1 mg/kg intravenously, repeated every 5 minutes
- C Adrenaline 1:1000, 0.01 mg/kg intramuscularly in the anterolateral thigh, maximum 0.5 mg ✓
- D Hydrocortisone 100 mg intravenously as the first drug, adrenaline only if no response
Correct answer: C. Adrenaline 1:1000, 0.01 mg/kg intramuscularly in the anterolateral thigh, maximum 0.5 mg
Explanation
AEFI anaphylaxis is treated with adrenaline 1:1000 at 0.01 mg/kg given intramuscularly into the anterolateral thigh, capped at 0.5 mg, repeated every 5 to 15 minutes if needed. The intramuscular thigh route gives faster absorption than subcutaneous or deltoid routes. Intravenous 1:10,000 adrenaline is for cardiac arrest or refractory shock under monitoring, not the first step. Corticosteroids act too slowly and are adjuncts, never the first drug.
Reference: WHO Immunization in Practice, 2015 update ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.